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Traditional psychoanalysis is known to be a lengthy and costly therapeutic method. The treatment is prolonged and expensive, and an analysis, or course of counseling, is estimated to require 5 years or more with four or five sessions per week. The time and expense involved with psychoanalysis are prohibitive to many, and practitioners of the traditional psychoanalysis method are not ubiquitous; practitioners require intensive training, making the availability of these professionals limited. However, because psychoanalysis is most often not covered by health insurance in most locations in the United States, many analysts may negotiate their fees with clients whom they feel they can help but who have financial difficulties (Wallerstein, 2000).

A further consideration with respect to cost is that in circumstances when lower cost treatment is provided to the client because the analyst is funded by the government, then psychoanalytic treatment occurs at the expense of other forms of more effective treatment. A related criticism is of the direct importance to the mental health of the community. Because this counseling is less available and less affordable compared with some other forms of treatment, critics suggest that the practice of this treatment is generally less valuable than other forms (Wallerstein, 2000).

Early critics of psychoanalysis believed that its theories were based too little on quantitative and experimental research and too much on the clinical case study method. Psychoanalytic practice has profound limitations as a form of research, because many of the existing studies are primarily case studies and therefore have limited broad external validity (Tuckett, 1994). Most practitioners of psychoanalysis feel this theory is most suitable for treating neuroses but less effective when treating personality disorders or psychoses. A survey of scientific research suggests that while personality traits corresponding to Freud's oral, anal, and genital phases can be observed, they do not necessarily manifest as stages in the development of children. These studies also have not confirmed that such traits in adults result from childhood experiences (Fisher & Greenberg, 1977). Primarily associated with adult treatment, the effects of psychoanalytic theory have also been studied in children with certain diagnosed disorders. Children with depression, autism, and conduct disorder seem to benefit only marginally from psychoanalysis, whereas children with severe emotional disorders, including three or more Axis I diagnoses, seem to exhibit fewer impairing symptoms when engaged in psychoanalytic treatment. It is interesting to note that for this group, the theory itself seems to encourage positive change rather than the frequency of sessions (Fonagy, 2003).

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